- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $114.82 / $446.68
| Facility | | $11.48 | $114.82 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $8.51 / $15.85
| Professional | | $5.62 | $8.51 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.75 / $6.61
| Professional | | $4.57 | $5.75 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $28.84 / $54.95
| Facility | | $10.23 | $28.84 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.50 / $9.55
| Professional | | $5.01 | $5.50 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $14.13 / $37.15
| Facility | | $8.51 | $14.13 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $9.55 / $15.14
| Professional | | $6.61 | $9.55 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.00 / $10.00
| Facility | | $9.55 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $20.89 / $51.29
| Facility | | $10.96 | $20.89 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.92 / $15.85
| Professional | | $5.37 | $6.92 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $100.00
| Facility | | $79.43 | $79.43 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.80 / $15.49
| Professional | | $8.51 | $13.80 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $17.38 / $316.23
| Facility | | $7.24 | $17.38 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.51 / $16.98
| Professional | | $5.01 | $8.51 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.94 / $7.94
| Professional | | $7.08 | $7.94 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,344.23 / $3,019.95
| Facility | | $2,187.76 | $2,344.23 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.55 / $28.18
| Facility | | $7.59 | $9.55 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.92 / $15.85
| Professional | | $5.37 | $6.92 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $9.55 / $11.48
| Facility | | $4.27 | $9.55 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.50 / $9.55
| Professional | | $3.98 | $5.50 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.90 / $9.55
| Professional | | $3.72 | $4.90 | $9.55 |